CREDIT APPLICATION

Please fill out the following online credit application and one of our credit specialists will contact you.

BUSINESS INFORMATION

Legal Business Name: *

Business Address *

Floor/Suite:

City: *

State: *

Zip Code *

Phone Number: *

Email Address

Type of Business: *

Federal Tax ID:

Time In Business Under Current Ownership (Yrs): *

BUSINESS OWNERSHIP

Owner Type: *

Sole Owner

Partnership

Corporation

LLC

LLP

Other

First Name: *

Last Name: *

Title:

Social Security #: *

Home Address:

Floor/Suite:

City: *

State: *

Zip Code *

Phone Number: *

Email Address *

% of Ownership: *

2nd Owner/Gaurantor Name:

Title:

Social Security #:

Home Address:

Floor/Suite:

City:

State:

Zip Code

Phone Number:

% of Ownership:

Do any of the applicants have a commerical drivers license (CDL) ? *

Is at least one of the applicants a US Citizen ? *

If you are a trucking compnay how many other commerical units do you have if any? *

EQUIPMENT

Vendor:

Contact:

Phone Number:

Vendor Address:

Floor/Suite:

City

State:

Zip Code

Amount $: *

Available Down Payment if needed $: *

Preferred Term (Months): *

24

36

48

60

Flexible

Type of Equipment: *

Equipment Type *

New

Used

Equipment Description and Comments (Year/ Make/Model Helpful if possible):

Additional comments regarding this transaction that you would like us to know about:

I agree that by submitting this form, I, the undersigned individual, recognizing that his or her individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes the above named business credit provider and any assignee, lender or funding service that may be utilized to obtain and use a consumer credit report on the undersigned, now and from time to time, as may be needed in the credit evaluation and review process and waives any right or claim they would otherwise have under Fair Credit Reporting Act in the absence of this continuing consent.